老年急性心肌梗死并心源性休克冠状动脉介入治疗的临床效果研究(1)

http://www.100md.com 2018年4月30日 《医学信息》 2018年第17期

     摘 要：目的 探讨冠状动脉介入治疗老年急性心肌梗死并心源性休克的临床价值。方法 回顾性分析2013年7月～2017年11月在我院接受治疗的155例老年急性心肌梗死并心源性休克患者的临床资料，根据治疗方式分为溶栓组(80例)与介入治療组(75例)。比较两组患者尿量、心率、左心室射血分数(LVEF)以及血管开通率。结果 治疗后，介入组尿量多于溶栓组，HR值低于溶栓组，差异有统计学意义(P<0.05)；住院前及出院6个月后，介入组LVEF值均高于溶栓组，差异有统计学意义(P<0.05)；溶栓组出院6个月后，LVEF值高于出院前，差异有统计学意义(P<0.05)；介入组出院前后LVEF值对比，差异无统计学意义(P>0.05)；介入组血管开通率为93.33%，高于溶栓组的77.50%，差异有统计学意义(P<0.05)。结论 冠状动脉介入为治疗老年急性心肌梗死并心源性休克患者的有效手段，可有效改善血液流变学、尿量，利于心功能恢复。

    关键词：老年急性心肌梗死；心源性休克；冠状动脉

    中图分类号：R542.22 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.17.031

    文章编号：1006-1959(2018)17-0101-03

    Abstract：Objective To investigate the clinical value of coronary intervention in elderly patients with acute myocardial infarction and cardiogenic shock.Methods The clinical data of 155 elderly patients with acute myocardial infarction and cardiogenic shock who were treated in our hospital from July 2013 to November 2017 were retrospectively analyzed.According to the treatment，it was divided into thrombolytic group(80 cases)and interventional treatment group(75 cases).Urinary volume，heart rate，left ventricular ejection fraction(LVEF)，and vascular access rate were compared between the two groups.Results After treatment，the urine volume of the intervention group was higher than that of the thrombolysis group，and the HR value was lower than that of the thrombolytic group，the difference was statistically significant(P<0.05).Before hospitalization and 6 months after discharge，the LVEF values of the intervention group were higher than those of the thrombolysis group，the difference was statistically significant(P<0.05).After 6 months of discharge in the thrombolytic group，the LVEF value was higher than that before discharge，the difference was statistically significant(P<0.05). The LVEF value of the intervention group before and after discharge was not statistically significant(P>0.05)；the vascular access rate of the intervention group was 93.33%，which was higher than that of the thrombolytic group 77.50%，the difference was statistically significant(P<0.05).Conclusion Coronary artery intervention is an effective method for the treatment of elderly patients with acute myocardial infarction and cardiogenic shock.It can effectively improve hemorheology and urine output and facilitate cardiac function recovery.

    Key words：Elderly acute myocardial infarction；Cardiogenic shock；Coronary artery

    心源性休克属急性心肌梗死的严重并发症之一，同时也是导致该疾病患者院内死亡的主要原因，易对患者生存质量造成威胁，故寻求有效的治疗方案尤为重要[1]。溶栓为治疗该疾病的保守手段，但其有严格的时间窗要求及溶栓禁忌证，致使部分患者易错过最佳治疗时机。而冠状动脉介入术虽在一定程度上会损伤机体完整性，但其切口较小，且治疗效果较好[2，3]。基于此，本研究进一步探讨冠状动脉介入术对老年急性心肌梗死并心源性休克患者LVEF值等方面的影响，现报道如下。(张畅)

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